Traveling, Meds, and Insurance

[coileurs]

I'm thinking about taking a sabbatical and traveling around Europe for a year. The only thing holding me back is that I have a good insurance plan currently, and my medications are $30 a month (complera).

I'm hoping to live and work for a few months at a time in various cities across Europe for the next year. I'm wondering if anyone has done something like this and can offer any advice on alternatives to insurance or programs that are offered to keep me on my meds.

[Jeff G]

I really cant offer the answer to your question but I will caution you to do your homework if your intention is to change insurance company's or cancel the good insurance you already have . I made the mistake of allowing my insurance to lapse when I was young and the consequences of doing so follows me to this day .

I was recently investigating buying meds abroad and I found I could afford to buy some meds out of pocket because they are considerable less costly in some country's .

Welcome to the forum , hope you get what you need and have a great adventure . 

[Buckmark]

I'm thinking about taking a sabbatical and traveling around Europe for a year. The only thing holding me back is that I have a good insurance plan currently, and my medications are $30 a month (complera).

I'm hoping to live and work for a few months at a time in various cities across Europe for the next year. I'm wondering if anyone has done something like this and can offer any advice on alternatives to insurance or programs that are offered to keep me on my meds.

I don't know where you live, but I assume you are currently living somewhere outside Europe (US, Canada, Asia?) and are looking towards Europe as a change of scenery.  Putting the question of meds aside for the moment, if you are planning to work in another country you should first make sure your work Visa and/or any necessary required work permits are in order.  There has been quite a crackdown in the past few years over Visas and work permits especially, partly because it is so easy for many of us to work remotely and stay connected, partly because the economic downturn has made governments very protective of jobs.  If you have this all in order, that's more than half the battle.

As far as the meds are concerned, I'm hoping some of our other members will chime in here.  Jeff G makes a good point about being wary of letting your insurance lapse.  Others may have some information on how to obtain meds in Europe.  Some have had friends in the US fill the prescriptions, and then ship them to Europe, but there's always a gamble with customs when you do that.  The only good news is that meds have *got* to be cheaper in Europe, than in the US (if that's where you are currently).

Welcome to the forums...

Henry

[mecch]

Meds are very expensive in Western Europe.

Most western european countries have socialised medicine so the patient isn't paying the expensive retail price but the state is, of course!

The originating Pharma companies (such as Merck, etc.) are not offering much difference in pricing to rich countries.

I know that pharma companies do offer radically lower prices - they have tiers of pricing (countries are put into "categories" 1, 2, etc,) to cover the range from very poor countries, through "developing", then rich.  This isn't at all my knowledge area but there are interesting reports on it, for instance here:
http://utw.msfaccess.org

(Some people assume that the only drugs that are cheap in countries that do have very low prices, are "generics".  But thats not always the case.)

Anyway, if you are walking into a pharmacy in Western Europe and paying retail price, I wouldn't expect any bargains.  Maybe a bit cheaper than this or that other rich country, but still quite impossible out of pocket....

[coileurs]

Thanks for replies. Couple of things I should clarify:

I'm from the US. Currently in NYC.

I work fulltime now, but my goal is to work for the next year as a consultant, picking up contract jobs and working remotely for the most part.

There are a lot of work opportunities in my field in Europe (and Asia)

My health insurance now is great, and if I were to pay for Complera out of pocket it would be something like 2k per month. However, there are several programs that help low income, and/or part-time employee HIV patients here in NYC. I think most of them are based on proof of income.

I was under the impression that some european countries have socialist health care, and similar programs that would make paying for HIV meds possible.

I would also gauge which cities to work in based on how affordable HIV healthcare would be.

[Ann]

I was under the impression that some european countries have socialist health care, and similar programs that would make paying for HIV meds possible.

That "socialist healthcare" is for residents, not people from other countries taking a jolly sabbatical in their country. "Socialist" healthcare isn't free - it's paid for by our taxes and other paid-to-government things, such as national health contributions made through your employment (in the UK).

You can't expect to rock up in a country with national healthcare, work for a few months, and suddenly get free or cheap (basically subsidised by the permanent residents) meds or healthcare.
 

[Jeff G]

Damn , and I was gonna visit Amsterdam for a free scrotum reduction . 

[coileurs]

That "socialist healthcare" is for residents, not people from other countries taking a jolly sabbatical in their country. "Socialist" healthcare isn't free - it's paid for by our taxes and other paid-to-government things, such as national health contributions made through your employment (in the UK).

You can't expect to rock up in a country with national healthcare, work for a few months, and suddenly get free or cheap (basically subsidised by the permanent residents) meds or healthcare.

In my defense, and at the risk of being too political, I'm definitely a proponent of social/national care in America, and everywhere. There are programs in the states that help non-residents, and I obligingly pay my taxes without complaints. It may sound naive or juvenile, but I don't have a problem taking advantage of similar programs abroad.

Also I shouldn't have used the term "sabbatical" loosely - in reality I'm exploring the next chapter in my life. Any of the countries I'm traveling to can (and hopefully will) be a place I reside long term/permanently.

[jkinatl2]

Yeah, I gotta tell you, unless you are pretty well off and plan on staying that way for the foreseeable future, you would be ill-advised to dump your steady job and insurance with HIV infection/treatment.

THAT is probably one of the hardest adjustments to having HIV these days. Used to be side effects, but now it's having to plan long-term for your treatment and meds.

Like Ann said, most European countries will not offer non-residents free treatment, and treatment in most Western Europan countries rivals the US in full retail cost. You might find a similar drug regimen (not one pill a day, I don't think - not for Complera) in India or the like, but remember: once you sut your ties with an insurance company, you will have a difficult time finding affordable insurance again.

Which means you have to stay relatively wealthy (the twelve grand per year for Complera doesn't cover twice-yearly labs and the like) or remain fairly poor to qualify for drug assistance/Ryan White.

Sorry that this sounds gloomy. But you have it really lucky, having a steady job you are capable of doing and insurance to cover your treatment and meds. If you turn your back on those things, you really do so at your own peril.

*modofied to add:

I notice you responded while I was half-assedly spell-checking.

You really, really need to do your homework regarding HIV and living abroad. Most places with socialized medicine will NOT cheerfully accept HIV positive people as immigrants, due to the estimated cost of treatment and burden on the resources. Now it might well be that you have a special set of skills that would make Western Europe bloodthirsty to get it's/their hands on you. If so, awesome!

But seriiously, think this through as thoroughly as you can. And do your homework. Sadly, the HIV infection is an anchor you have to carry around until the cure, and it will dictate many, many aspects of your professional and personal life.

I'm all for socialized healthcare as well. I don't see it happening in the USA any time soon, though. And other countries (even Canada, the politest country!) do not welcome foreigners with HIV into their healthcare systems gladly.  What you want to do might actually be workable, but it will take meticulous planning and more forethought than I can imagine.

[Jeff G]

I'm repeating myself . Think it over a thousand times before making any change to your health care or insurance , especially insurance .

I promise you that will regret it if you don't due your homework . I rarely get into the financial aspects of living with HIV , especially when addressing issues with people coming to terms with an HIV infection because there are sobering realities that must eventually  be faced for all of us on treatment  . Please understand that advise that's handed out in this forum is for others to benefit from as well , so its good to have this discussion even if parts of it don't apply to you , oddly enough , insurance and treatment issues have taken the better part of the last two weeks of my life and it all stems from not so well thought out decisions I made 30 years ago .
 
I think you should continue to try and find ways to make your dreams come true . I have managed to travel quite extensively in my life but I did it with solid planning and meds in tow . You can travel through Europe if you want to but the reality is subsidized medications isn't going to be an option for you .

[coileurs]

thanks for all the advice. I've figured out work visas for Berlin since I have a potential full time job lined up in there (as of today!). Might be a good entry point for me. Subsidized healthcare may not be an option, but I will still research alternative insurance policies. I was once a member of the freelancers union in NYC which was a decent insurance program for consultants, not sure if there is anything like that elsewhere, but will look.

[Jeff G]

There may be insurance options I'm not aware of but ALL of the country's that I personally researched this past week would not pay for anything that was a preexisting condition until a few years down the road . I hope you give us an update on what you find out ... please  .

 

[mecch]

I bet if you have a work permit and/or resident permit to be in some European country, you might very well find a more optimistic picture, as to access to subsidised health care. 
My response was based on the idea you weren't trying to be legit in Europe, just passing through for a year.
I hope that Berlin job works out for you!  You might find, after a year experiment,  that you enjoy working and living for the long term, in a country where having HIV is less financially difficult to manage... Still complicated, of course, but for the time being less complicated than in the States, for example.

[mikejh]

If you have a valid work visa for EU you can get health care and medication almost free in most countries, I live in NY but know that in Sweden for example you get the hiv Meds incl Atripla free and other Meds you pay maximum SKR 2.000 per year that's around
$390,00 max for the year.